Well, things are escalating

The new doc ordered basic labs. My eGFR has always been consistent 90+. It is now just barely below normal (59). While the distance from normal (60) is minor, the large deviation from a very well-established baseline over a period of months is quite concerning to me and should be to a physician. I have left my physician a note expressing my concern. I doubt anything comes of it. The medical system is simply broken. They have become button-pushers, not men and women of science.

I know exactly what is going on in my body and I'm coping - barely. So far, I've been able to keep things "normal" for the household. Obviously, my wife is well aware of my issues, but the kids and her family are not and I am very glad about that. They should not be subjected to this. How can you have any confidence in the medical system after watching this? UPDATE: Sure enough, my Rheumatologist thinks it is dehydration because, as usual, my BUN was also elevated. They suggested retesting via my PCP if I am still concerned. Yes, I am still concerned. After being without fluids for 72 hours in November, my Calcium, Chloride, Sodium, and Potassium were all normal (which is quite odd, btw) and my eGFR was 87. So, no, I do not think it was dehydration and I would like retested.

A significant problem is that every blood draw permanently removes additional circulatory volume from my system due to how my heart works via suction. The article was very clear on this point. You might think what's a few mL here or there. But, I've been in volume depletion for years. The article was quite clear that every blood draw mattered. As the volume decreases, the blood flow through the kidneys lessens. The vessels narrow and they work even less. For some reason, the subjects even slept sitting up to increase the blood flow through their kidneys. It said that when they lay down, the heart didn't have to work as hard so more flow went around the kidneys. I cannot totally explain it, but sitting up causes the heart to work hardest because of the vertical distance between the feet and the heart. There were illustrations with a dotted line coming out from the heart and a vertical line showing the distance between the feet and the heart.